Abelson Julia, Wagner Frank, DeJean Deirdre, Boesveld Sarah, Gauvin Franςois-Pierre, Bean Sally, Axler Renata, Petersen Stephen, Baidoobonso Shamara, Pron Gaylene, Giacomini Mita, Lavis John
Department of Clinical Epidemiology and Biostatistics,McMaster
University of Toronto.
Int J Technol Assess Health Care. 2016 Jan;32(4):256-264. doi: 10.1017/S0266462316000362. Epub 2016 Sep 27.
As health technology assessment (HTA) organizations in Canada and around the world seek to involve the public and patients in their activities, frameworks to guide decisions about whom to involve, through which mechanisms, and at what stages of the HTA process have been lacking. The aim of this study was to describe the development and outputs of a comprehensive framework for involving the public and patients in a government agency's HTA process.
The framework was informed by a synthesis of international practice and published literature, a dialogue with local, national and international stakeholders, and the deliberations of a government agency's public engagement subcommittee in Ontario, Canada.
The practice and literature synthesis failed to identify a single, optimal approach to involving the public and patients in HTA. Choice of methods should be considered in the context of each HTA stage, goals for incorporating societal and/or patient perspectives into the process, and relevant societal and/or patient values at stake. The resulting framework is structured around four actionable elements: (i) guiding principles and goals for public and patient involvement (PPI) in HTA, (ii) the establishment of a common language to support PPI efforts, (iii) a flexible array of PPI approaches, and (iv) on-going evaluation of PPI to inform adjustments over time.
A public and patient involvement framework has been developed for implementation in a government agency's HTA process. Core elements of this framework may apply to other organizations responsible for HTA and health system quality improvement.
由于加拿大及全球的卫生技术评估（HTA）组织都在寻求让公众和患者参与其活动，因此一直缺乏指导有关该让谁参与、通过何种机制以及在HTA过程的哪些阶段参与等决策的框架。本研究的目的是描述一个用于让公众和患者参与政府机构HTA过程的综合框架的制定情况及成果。
该框架以国际实践和已发表文献的综合分析、与地方、国家和国际利益相关者的对话以及加拿大安大略省一个政府机构的公众参与小组委员会的审议为依据。
实践和文献综合分析未能确定让公众和患者参与HTA的单一最佳方法。应根据每个HTA阶段、将社会和/或患者观点纳入该过程的目标以及相关的社会和/或患者价值观来考虑方法的选择。最终形成的框架围绕四个可操作要素构建：（i）公众和患者参与HTA的指导原则和目标，（ii）建立支持公众和患者参与工作的通用语言，（iii）一系列灵活的公众和患者参与方法，以及（iv）对公众和患者参与进行持续评估以便随着时间推移为调整提供依据。
已制定一个公众和患者参与框架，供在政府机构的HTA过程中实施。该框架的核心要素可能适用于其他负责HTA和卫生系统质量改进的组织。
